Individual
BRANDY DAWN HOLMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1603 CASE ROAD, LOGANSPORT, IN 46947
(574) 737-7404
Mailing address
3125 EAST 900 SOUTH, WALTON, IN 46994
(574) 753-1707
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000817A
IN
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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